Natl. J. Physiol. Pharm. Pharmacol. (2025), Vol. 15(1): 98-101

Original Research

10.5455/NJPPP.2025.v15.i1.17

Quality of life among adolescent health care students in Chennai: A cross-sectional study

Jenny Jayapal1, Vadivel Sambhasivam1, Pramila Chengalvarayan Subramani2, Divya Dharshini Rubagavathi Subramanian3, Sweshika Babu4, Harini Sampath Kumar1 and Srihari Ramamoorthy1*

¹Department of Physiology, PSP Medical College Hospital and Research Institute, Chennai, India

²Department of Biochemistry, PSP Medical College Hospital and Research Institute, Chennai, India

³Department of Physiology, SRM Medical College Hospital and Research Centre, Kattankulathur, India

⁴Department of Physiology, Sri Venkateswaraa Medical College Hospital and Research Insitute, Sri Venkateswaraa Medcity, Padianallur, India

*Corresponding Author: Srihari Ramamoorthy. Department of Physiology, PSP Medical College Hospital and Research Institute, Chennai, India. Email: itisphysio4u [at] gmail.com

Submitted: 10/12/2024 Accepted: 26/12/2024 Published: 31/01/2025

---

Abstract

Background: Health is the basis for an individual’s well-being and survival. Quality of life (QoL) is a subjective perception of an individual’s position in life that acts as a holistic factor in contributing to and determining the health and well-being of an individual. Health care education is a challenging and stressful academic path. Adolescence is defined as a period of “storm and stress” and this is the phase during which an individual steps into college life, which again is a transitional and stressful period.

Aim: This study aimed to assess the QoL of adolescent health care students in Chennai, India.

Methods: This cross-sectional study was initiated after obtaining Institutional Ethics Committee clearance. First- and second-year Nursing and Allied Health Sciences (AHS) students (18–19 years) were included in the study (n - 113). After obtaining the basic details, QoL was assessed using the World Health Organization Quality of Life Abbreviated questionnaire questionnaire, which contains 26 items assessing physical, psychological, social, and environmental health.

Results: The majority of the study participants were from year I (56.6%) and AHS department (53.1%). Gender-wise, female participants (70.8%) were more than males. QoL scores showed that adolescent health care students had moderate QoL, and females were found to have better physical (p: 0.04) and environmental health (p: 0.001) scores than their counterparts.

Conclusion: This study showed that adolescent health care students have moderate QoL, and females were found to have better QoL than males. Adolescence is the prime period of life. Thus, supportive measures, such as foundation sessions and orientation classes, should be provided to adolescent health care students to ensure a healthy life.

Keywords: Quality of life, adolescents, Health care education, Health, Academic load.

---

Introduction

“Health is wealth” is a well-known saying that has been pronounced and emphasized in mankind since ancient times. WHO has defined health as “physical, mental, and social well-being and not just absence of disease or infirmity.” As humans are social animals, health forms the basis for survival. An individual’s life is validated based on the quality of living (QoL) rather than his chronological age (quantity). Hence, quality of life could be considered a holistic factor in determining well-being of an individual (Mandeep Kaur et al., 2023).

WHO describes QoL as an “individual’s subjective perception about their position in life.” Felce and Perry suggested three factors that determine an individual’s QoL—living conditions are objective in nature; subjective perceptions of physical, mental, and social health; and individual morals and aspirations (Husam Malibary et al., 2019). QoL has been found to be influenced by factors such as age, gender, socioeconomic status, education, and individual personalized behavioral factors (Li et al., 2022).

Health care is a service sector and a noble profession that is recognized worldwide. Creating awareness and prevention of diseases, treating, and healing patients, and promoting health via high-quality research are the main components of health care. Health care is a stressful profession with a very high rate of burnout and low QoL (Seol et al., 2023). A study conducted among 200 Doctors and Nurses showed that health care workers have elevated stress and poor QoL, which is associated with poor family time and recreational activities (Kumar et al ., 2018). A study conducted among 873 primary health care workers in a rural area showed that 74.6% of health care workers had poor QoL and social support (Asante et al., 2019). This highlights the fact that health care professionals are stressed and have poor QoL regardless of geographical area.

Health care education is considered interesting and challenging worldwide. Health care education involves high academic load, clinical postings, and field visits, which demand a more dedicated time for preparation and execution. Health care students were found to have extended classes, reduced night sleep, and frequent exams leading to decreased sleep, stress, anxiety, and suicidal thoughts (Tol et al., 2013). A study among 408 Korean medical students showed that medical students have higher levels of depression, internet addiction, and low QoL (Seol et al., 2023). Similar to medicine, other health care courses, such as nursing, physiotherapy, pharmacy, and allied health sciences, also have enormous academic loads, hospital duties, documentation work, and field visits, which are associated with enormous stress leading to poor QoL.

College education is the phase of life in which individuals are in their adolescence. The World Health Organization has defined adolescence (10–19 years) as a period of “storm and stress.” Adolescence is divided into early (10–14 years), middle (15–16 years), and late adolescence (17–19 years). Late adolescence is a transition period during which individuals progress to college education. Any transition demands a lot of learning and unlearning—inducing stress. Adolescence per se is associated with stress due to physical (hormonal changes) and psychosocial factors (UNICEF 2006). Health care education involves enormous academic load, clinical postings, documentation of reports, and field visits, which are again associated with enormous stress, leading to poor QoL. Thus, stress and health care education can challenge QoL. Hence, this study aimed to assess the quality of life of adolescent health care students in Chennai, Tamil Nadu.

---

Materials and Methods

The current cross-sectional study was initiated after obtaining clearance from the Institutional Ethics Committee and was conducted among first- and second-year nursing and allied health sciences (AHS) students. Participants in their late adolescence (18–19 years) were included, and the study population consisted of 33 males and 80 females (n - 113). After obtaining informed consent, quality of life was assessed using the World Health Organization Quality of Life Abbreviated questionnaire (WHOQOL-BREF), which contains 26 questions, which is an abbreviated version of the original WHOQOL 100. The questionnaire contains 26 items. The first two items asked about their overall health and quality of living, and the remaining 24 items assessed the four domains of well-being, such as physical health (eight items), psychological health (six items), social health (three items), and environmental health (nine items). Each question has a five-point Likert scale option ranging from 1 to 5, where 1 indicates very poor/never and 5 indicates satisfied/always. The score possibilities are between 8 and 40, 6 and 30, 3 and 15, and 9 and 45 for physical, psychological, social, and environmental health, respectively. Scores for all domains are summed up; higher scores indicate better QoL (Alkatheri et al., 2020, Woon et al., 2021).

The English version of the questionnaire was adapted for the participants. To avoid any errors, the participants were asked to fill out the questionnaire at their convenient time. The responses were collected and tabulated. The data were analyzed using SPSS software version 18.0.

---

Results

This cross-sectional study was conducted among late adolescent males (33) and females (80) pursuing nursing and AHS courses in Chennai (n - 113).

Table 1 presents the baseline characteristics of the study population. Results have shown that sex-wise females (70.8%) were slightly higher than males (29.2%), and the maximum number of study participants was 19 years old (62%). A higher percentage of students were from the AHS department (53.1%), followed by nursing (46.9%), and most of the study participants were I-year students (56.6%).

Table 2 presents the scores of the study population in each health domain of the QoL questionnaire.

Table 3 presents the sex differences in each health domain in the QoL questionnaire. Females were found to have better physical (p: 0.04) and environmental health (p: 0.001) than males and were found to be statistically significant.

Table 1. Baseline characteristics of the study population.

Table 2. QoL domains and study population.

Table 3. Gender differences in QoL scores among the study population.

---

Discussion

The current cross-sectional observational study aimed to assess the QoL, of adolescent health care students (Nursing and AHS). Adolescents are prone to psychophysiological changes such as hormonal surges, changes in physique, gender realization, and demanding autonomy (Arnet 1999). Furthermore, health care education comprises academic, clinical, and field visit loads leading to stress and poor QoL. Thus, the current study assessed QoL among adolescent health care students in Chennai.

The majority of the participants were females. Generally, nursing and allied health professions are more preferred by females than males (Snyder et al ., 2021), which could be the reason for the increased number of female participants in our study. A higher percentage of participants were found from the I-year and AHS courses, which is due to the increased physical availability of students in the classroom in the first year. AHS students attend more classroom sessions than nursing students in their first and second years, leading to more participants from AHS than nursing.

Adolescent health care students were found to have moderate physical, psychological, social, and environmental scores, indicating moderate QoL. Adolescence and young adulthood are seen as the peak periods of physical health. Compromised night sleep, increased and prolonged clinical postings, field visits, and poor lifestyle habits among the current generation could have been the cause of the moderate physical scores of adolescent health care students (Miguel et al., 2021).

The bio-psychosocial model interconnects and links the mind, body, and social health of individuals. School-to-college transition, new environment and people, hostel life, reduced night sleep, increased academic load, high demands and expectation from family and society, peer pressure, interpersonal relationship issues, and psychosocial stressors during adolescence could have been the cause of moderate QoL scores in psychological, social, and environmental health domains among adolescent health care students (Ashok et al., 2017; Arif et al., 2019; Batabyal et al., 2019). A study conducted among 873 Chinese health workers (nurses, physiotherapists, pharmacists, and community workers) showed that 74.6% of them had poor QoL. Higher workload, prolonged work timing, and job dissatisfaction were found to be factors associated with poor QoL (Asante et al., 2019).

Gender-wise, females were found to have better physical and environmental scores than males. A study conducted among medical and nonmedical female students showed that female medical students are more stressed than their counterparts, which is attributed to their increased academic load and increasing age (Al-Dabal 2010). A similar study conducted in Riyadh among 479 medical and other health care students showed that females had higher QoL scores (Alkatheri et al., 2020). In our study, females were found to have better physical and environmental scores. Patient care services require a lot of patience and compassion, and these behavioral traits are associated with female sex hormone estrogen (Hwang et al., 2021). In addition, patient care education is more preferred by females than males (Snyder et al., 2021). As females have a natural inclination toward health care professions, they can lead better physical and environmental health than their counterparts.

---

Conclusion

The current study shows that adolescent health care students have moderate QoL. Females were relatively found to have better QoL than males. Adolescence forms the basis of an individual’s life. A healthy adolescent life gives a healthy, confident career, and life. Furthermore, adolescents are the future pillars of the country. Hence, supportive measures, such as foundation sessions and orientation classes, should be provided to adolescent health care students to ensure a healthy life.

---

Acknowledgments

The authors acknowledge the study participants for their participation and cooperation throughout the study.

Funding

Self-funded study.

Authors’ contributions

Concept and design of the study: Srihari R, Jenny J, and Vadivel S.

Acquisition, analysis, and interpretation of data: Jenny J, Srihari R, Pramila C S, Divyadharshini R S, Sweshika B, and Harini S.

Drafting and revising manuscript: Srihari R, Jenny J, Vadivel S, Pramila C S, Divyadharshini R S, Sweshika B, and Harini S.

Final approval for the version to be published: Srihari R, Jenny J, Vadivel S.

Conflict of interest

The authors declare no conflict of interest.

Data availability

Available.

---

References

Al-Dabal, B.K., Koura, M.R., Rasheed, P., Al-Sowielem, L. and Makki, S.M. 2010. A comparative study of perceived stress among female medical and non-medical university students in Dammam, Saudi Arabia. Sultan. Qaboos. Univ. Med. J. 10(2), 231–240.

Alkatheri, A.M., Bustami, R.T., Albekairy, A.M., Alanizi, A.H., Alnafesah, R., Almodaimegh, H., Alzahem, A., Aljamaan, K., Zurnuq, S. and Qandil, A.M. 2020. Quality of life and stress level among health professions students. Health Prof. Educ. 6, 201–210.

Arnett, J.J. 1999. Adolescent storm and stress. Am. J. Psychiatry. 54(5), 317–326.

Arif, N., Yadav, S.S. and Gupta, S. 2019. An epidemiological study of stress among adolescent of urban and rural Moradabad. Int. J. Med. Sci. Public Health. 8(9), 712–717.

Asante, J.O., Li, M.J., Liao, J., Huang, Y.X. and Hao, Y.T. 2019. The relationship between psychosocial risk factors, burnout and quality of life among primary healthcare workers in rural Guangdong province: a cross-sectional Study. BMC Health Ser. Res. 19, 447.

Ashok, V., Rajan, A. and Maben, R. 2017. Stressors in adolescence: an analytical cross-sectional study. Ind. J. Child. Health 4(1), 72–74.

Batabyal, A., Bhattacharya, A., Thaker, M. and Mukherjee, S. 2019. A longitudinal study of perceived stress and cortisol responses in an undergraduate student population in India. PLoS One 16(6), e0252579; doi:10.1101/867184

Hwang, W.J., Lee, T.Y., Kim, N.S. and Kwon, J.S. 2021. The role of estrogen receptors and their signaling across psychiatric disorders. Int. J. Mol. Sci. 22, 373. https://doi.org/10.3390/ijms22010373

Kaur, M. and Kaur, S. 2023. Concept of quality of life in health care research: a review. Int. J. Commun. Med. Public Health. 10(10), 3931–3937.

Kumar, A., Bhat, P.S. and Ryali, S. 2018. Study of quality of life among health workers and psychosocial factors influencing it. Ind. Psychiatry J. 27, 96–102.

Li, H.M. and Zhong, B.L. 2022. Quality of life among college students and its associated factors: a narrative review. AME Med. J. 7, 38.

Miguel, A.C., Tempski, P., Kobayasi, R., Mayer, F.B. and Martins, M.A. 2021. Predictive factors of quality of life among medical students: results from a multicentric study. BMS Psychol. 9, 36.

Snyder, A., Xiang, D., Smith, A., Esswein, S., Toubat, O., Di Capua, J., Kwan, J.M. and Daye, D. 2021. Gender disparities among medical students choosing to pursue careers in medical research: a secondary cross-sectional cohort analysis. BMC Med. Edu. 21(1), 591.

Tol, A., Tavassoli, E., Shariferad, G.R. and Shojaeezadeh, D. 2013. Health-promoting lifestyle and quality of life among undergraduate students at school of health, Isfahan university of medical sciences. J. Edu. Health Promot. 2, 11.

UNICEF. 2006. Adolescent development: perspectives and frameworks- a discussion paper. New York, NY: UNICEF.

Woon, L.S.C., Mansor, N.S., Mohamad, M.A., Teoh, S.H. and Leong Bin Abdullah, M.F.I. 2021. Quality of life and its predictive factors among healthcare workers after the end of a movement lockdown: the salient roles of COVID-19 stressors, psychological experience, and social support. Front. Psychol. 12, 652326; doi: 10.3389/fpsyg.2021.652326